Life care planning helps families get and pay for care that seniors need

Life care planning is a process for assuring that our loved ones can find, get and pay for the care they need to maintain their independence as long as possible and obtain the proper help when it is required.

While it is never too early to plan for the future, certain external events should definitely serve as triggers to move life care planning higher on our to-do list.

Basic planning documents: While every adult should have designated who can make medical and financial decisions on his behalf when he is not able to do so, fewer than half of us have valid powers of attorney and health care directives in place.

Family gatherings over the holidays provide the perfect opportunity to raise this subject. If adult children are not comfortable asking their parents whether they have these documents in place, the children can start the conversation by talking about how they are in the process of identifying the people they will be naming as agents in their own planning documents.  

If you know that your parents have prepared these documents, it is a good idea to suggest that they take a look at them again to make sure they will still accomplish their original objectives.

For example, are all of the agents named in the documents still living, healthy and willing to serve? If your parents’ wishes regarding end-of-life care have changed, does the health-care agent know what they would want? You can assure your parents or other family members that they don’t need to answer these questions to you, as long as they are thinking about them – and making the necessary changes as a result.

Diminished capacity: Seeing loved ones over the holidays whom we have not seen in a while provides a good opportunity to assess their capacity. While a person who seems a little more forgetful, or has received a diagnosis of mild cognitive impairment, is not immediately incapable of expressing an informed opinion about her own care, it is a warning sign that she and her family should put plans in place to provide the care that the person will likely need as the condition progresses.

Long-term care: The realization that a loved one requires long-term care, either because of a catastrophic event such as a fall or a stroke, or the progressive decline resulting from a condition like Alzheimer’s disease, is the situation that most often causes a family to begin life care planning.

If we know the person is no longer safe at home, we may consider whether assistance with dangerous activities such as showering and driving, and assuring that the person takes her medications and receives proper nutrition, will be enough, or whether that person needs to move to an environment that provides more support. And it is not possible to think about the necessary level of care without also considering how to pay for it.

Does the person have a long-term care insurance policy, against which it is now time to make a claim? Does he have his own assets, which should be restructured to maximize cash-flow and liquidity? Might he be eligible for veterans’ benefits that can offset some of the cost of care? And if the family needs to consider Medicaid, now or in the future, what is the impact of other financial decisions that we might make?

While all of these discussions can be difficult, we know that the sooner that plans are put into place, the greater the variety of options available to help our parents find, get and pay for the care that best meets their needs.

Marsha Goodman, a partner in the firm of Frazer, Ryan, Goldberg and Arnold, LLP, focuses her practice on Life Care Planning for seniors and their families. She has been recognized as a Certified Elder Law Attorney by the National Elder Law Foundation.

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